Controversial issues associated with the prescription of benzodiazepines by general practitioners and psychiatrists

Abstract

Background: Benzodiazepines are commonly used psychotropics frequently applied in ways not fully supported by the present state of scientific knowledge. These departures are usually based on considerations of clinical practice characteristics seldom fully acknowledged by Evidence Based Medicine.

Material/methods: To assess the basic knowledge that sustains the prescription of benzodiazepines, a questionnaire about its use composed of twelve statements which are either "right" or "wrong" was given to a representative sample of 194 general practitioners and 34 psychiatrists working for the Canary Islands Health Service. The correctness of the statements were evaluated against literature sources and the answers were analyzed according to those results.

Results: None of the participants answered all statements correctly. Six statements were incorrectly answered by more than 50%, another three by more than 40%, and only the remaining three were failed by less than 20% of the sample. If a score had been developed for each professional, general practitioners would have achieved a mean score of 4.9 points out of 10, whereas psychiatrists would have had a mean score of 6.1 out of 10.

Conclusions: Benzodiazepines are commonly used, safe and efficacious drugs, but the knowledge shown by health professionals with ample experience is not in agreement with the current state of knowledge on the matter. To better use these useful and old drugs, up-to-date knowledge is needed. Along the same line, the scientific knowledge related to an adequate psychoactive drug prescription should be revised, giving more importance to real circumstances from clinical practice.